Ebele Mogo argues that the Africa Rising narrative should prioritise the poor, not just the elite.

The Africa Rising narrative provides a language for us to imagine the African continent as an object of hope and not just pity. In this space Africa is an ideological and physical entity that faces other economies as an equal, a competitor even. This vision fills one with hope. Yet in most cities of the world from Glasgow to Lagos, what we mean by growth is often growth for the elite. All over the world, the same cities with wealth and skyscrapers also hide in their margins starvation, crime, poverty and disease.

Slums like this one in Accra result when people move into cities in search of opportunties. Photo Credit: Jeffrey Paller

Who is Africa Rising for if not for Africans? And if Africa is to rise for Africans, then the health and wellbeing of all African people must be central to the discourse on Africa Rising. Might we not imagine more from this narrative then? I put forward that the narrative needs a more robust thrust, one that prioritises health, equity and inclusion.

The need for health

Without proactive plans to integrate health into the vision of Africa Rising, this vision fails. Consider public health emergencies like the recent Ebola epidemic where we realise that economic growth without access to healthcare for all places everyone at risk. “Africa Rising” also brings with it the challenge of globalisation of unhealthy lifestyles. The fast food industry and the tobacco industry are also part of the economic investors who consider Africa to be the next frontier, thus worsening the rise of non-communicable diseases. Health systems on the continent are largely unprepared for this epidemiological shift. Health for all should be part of this vision of Africa Rising, to ensure that there is health infrastructure to prevent and manage communicable diseases and the growing epidemic of non-communicable diseases.

The need for equity

An inclusive vision of Africa Rising is also needed. While we might imagine that urban and economic growth will translate to opportunities for all, this is not typically the case. The poor often pay the price for urban development, with their slums, homes and shops razed to the ground to create new roads, without being offered alternatives. The poor also suffer from the double burden of communicable and non-communicable diseases as well as urban environmental threats such as flooding due to the precarious locations where they live. Since the poor work informally, they do not have the legitimacy to access resources like loans and mortgages, housing and healthcare. They are therefore excluded from social and economic power and growth opportunities which may be created from Africa’s Rising.

We can achieve a more inclusive vision of Africa Rising, one where the wellbeing of Africans is central, through comprehensive means. A few are discussed below:

Making the invisible visible

Several Africans live and work in the informal sectors. Requiring that people be formally employed and tax compliant to access mortgage and other benefits essentially excludes such people. Legitimation of informal spaces is needed, perhaps through cooperatives. Legitimation ensures that the informally employed too may keep their businesses, their houses, their land and access mortgages, loans and health insurance.

Context-specific solutions

A study once compared growth strategies in Malaysia and Sudan. In Malaysia, the strategy was effective because it was based on population needs and targeted resources toward areas of need. In Sudan the urban growth strategy focused on top-down recommendations without recognising local needs. It was unsuccessful. Strategies for growth must be informed by local needs, which can be ascertained by surveillance.

Inclusion

Social services like education and primary healthcare are necessities. Education affects social mobility, norms and health behaviours of a population. Without access to health, the poor are left with no or low quality healthcare and incur catastrophic health costs that push them deeper into poverty.

Moving beyond averages

Averages do not tell us much about what is really happening in our cities. Especially given the big gaps in living conditions between the richest urban dwellers and the poorest urban dwellers, average income, average life span among other aggregated metrics do not do much to guide action. A more helpful statistic would be one that breaks down the average outcomes in the city to show the distribution of resources, need and outcomes across population groups in the city. This will uncover intra-urban inequity and pinpoint areas of need much more clearly to help decision makers target resources accordingly.

Healthy urban design

An ideal urban Africa will not just be one with skyscrapers, Wi-Fi and elite gated communities. It will more importantly be designed for health. Many people move to cities in search of opportunities only for these municipal areas to kill them. Urban growth contributes to a higher demand for social resources like water and sanitation, safety, transportation, and housing. This often leads to slum proliferation, disease spread and traffic injuries in the population.

If Africa is to rise for all, the urban environment will be planned to ensure safety, sanitation and transport infrastructure, thus reducing pollution, traffic incidents, crime and stress. In addition, with the fierce strategy of tobacco companies in this region, zoning, advertising and land use restrictions will be in place to ensure that such industries do not have a field day on the African population thus worsening the rise of chronic diseases.

We need a robust and inclusive vision of Africa Rising, one that centres on the wellbeing of African people, integrates health with trade, and prioritises the poor not just the elite.

Ebele Mogo is a public health scientist and the president of Engage Africa Foundation. She is currently conducting her doctoral research on urban health and resilience in African cities, with the Lagos mega-city region as her prime focus. Follow her on twitter @ebyral and on her blog: Streetside Convos.

The views expressed in this post are those of the authors and in no way reflect those of the Africa at LSE blog or the London School of Economics and Political Science.

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